The health care system needs to evolve even further than it has and it has to do so at a lightning fast pace. New models of care and networks of providers are emerging now to better serve patients and communities. And at UnitedHealth Group, we are playing a lead role. Here's where you come in. As a manager within our pharmacy network contracting team, you'll guide the development and support of pharmacy provider networks, as well as unit cost management activities, through financial and network pricing modeling, analysis, and reporting. In return, you'll discover the impact you want and the resources, backing, and opportunities that you'd expect from a Fortune 5 leader.
This role is all about challenge and relationships.
- Manage unit cost budgets, target setting, performance reporting, and associated financial models
- Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
- Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards, and other key process controls
- Research and resolve pharmacy provider issues
- Influence and/or provide input to forecasting and planning activities
- Develop the pharmacy provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners
- Evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Establish and maintain strong business relationships with Pharmacy and Pharmacy Services Administration Organizations (PSAOs)
- Undergraduate degree or, in lieu of completed degree, 8+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 5+ years of experience in a network management-related role handling complex network providers with accountability for business results
- 2+ years of experience contributing to the development of product pricing and utilizing financial modeling in making rate decisions and managing a medical/pharmacy cost and administrative budget
- 2+ years of experience with provider contracting
Experience writing SQL queries
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job keywords: contracting, pharmacy, network contract, negotiations, Irvine, CA, California, Schaumburg, IL, Illinois, Eden Prairie, MN, Minnesota